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Sexual Abuse Of Psychiatric Patients In Prisons

Sexual abuse is shockingly common in the US prison system. A recent survey conducted by the Bureau of Justice Statistics concluded that about 200,000 prisoners are sexually abused each year.

Most of the abused prisoners are misplaced psychiatric patients who make especially vulnerable targets because they are less able to defend themselves and to be believed if they report infractions.

Although prison is clearly not the right place for psychiatric patients, almost a million are behind bars for crimes that could have been avoided if there were proper community treatment. Because there isn't, prison has become the default disposition for those patients who can't make it on their own. They usually get incarcerated for non-violent nuisance crimes that result from neglect, not evil intent.

The rate of overall institutionalisation for psychiatric patients has remained fairly constant for the past eighty years, but a trans-institutionalization has shifted them from hospitals to prisons. We have closed almost a million hospital beds, but have added the same number of cells for psychiatric patients.

It wasn't supposed to be this way. The dollars saved by closing beds were supposed to follow the patients, supporting them in community settings where they would have a richer and freer life. Instead, the states welched on their obligations to the mentally ill. Attempted to trim their budgets, and the states have paradoxically and irrationally spent the same dollars building inappropriate prison cells.

The obvious solution is to decriminalize mental illness, to fund adequate services for the mentally ill so that they don't wind up in prison. This is not rocket science. The rest of the developed world got this message two hundred years ago. The US lags far behind European countries and has been getting progressively worse as its always inadequate mental health system has been further dismantled by budget cuts.

These rape survey data also contribute to the discussion of whether forced psychiatric treatment is ever justified. Eleanor Longden and I recently wrote a blog agreeing that forced psychiatric treatment can on rare occasions be appropriate when there is otherwise the threat of clear and present danger to the patient or another. Eleanor's statement showed her great common sense and understanding since she had herself been the victim of considerable inappropriate psychiatric coercion.

Some of the responses to the blog were less enlightened by common sense and less informed about the risks prisons now pose to psychiatric patients. Although most coercion of psychiatric patients now occurs in prisons, not hospitals, some respondents argued that prison was really preferable to forced psychiatric treatment—it provided more protection of civil rights and was more justified because a crime had already been committed.

I am convinced of the sincerity of these advocates for the mentally ill, but am equally convinced they are now fighting the wrong fight. The risks and priorities have shifted—fifty years ago a million patients languished in snake pit hospitals, now they languish in much more dangerous and degrading snake pit prisons.

Psychiatric patients do not do well in negotiating the perils and routines of prison life. Too often they wind up in solitary confinement, which can drive anyone crazy. To get a full appreciation of depths of degradation of prison life for psychiatric patients you have to see and smell the rows of cells where extensive excrement smearing has become a last resort of desperation. And, as just documented by the prison system itself, psychiatruc patients are prime targets for sexual (and probably other forms) of violence.

Everyone interested in the welfare of psychiatric patients should join in the effort to end their barbarous imprisonment. The battle against inappropriate psychiatric coercion has largely been won; the much more urgent battle again inappropriate prison coercion needs all the help it can get.

You are a very curious creature. At some point in your career you realized that psychiatry was a scam. I cannot point exactly to the day when that happened, but you certainly get that you have made a living out of an institutionalized scam. Instead of denouncing the scam, you keep making excuses for it and showing your deeply totalitarian thinking along the way,

"Some of the responses to the blog were less enlightened by common sense and less informed about the risks prisons now pose to psychiatric patients."

"Although most coercion of psychiatric patients now occurs in prisons, not hospitals, some respondents argued that prison was really preferable to forced psychiatric treatment—it provided more protection of civil rights and was more justified because a crime had already been committed."

As one of those who wrote comments to the other entry, I sincerely prefer to be treated as a criminal defendant than to face a "civil commitment" proceeding. The rights of a criminal defendant are more protected than the rights of somebody who faces civil commitment.

Sorry, but as somebody whose only contact with psychiatric coercion has been the ruining of thousands of lives you are not qualified to judge the views of those of us whose lives have been ruined by actions like the one you defend. You are defending "benign rape" while those of us who have been raped are fighting for stopping all rape. There is no such thing as "benign rape" or "consensual rape". Rape, ie psychiatric coercion, is by definition evil, end of the story. I would civilly commit you for a few months so that you maybe change your "common sense".

"I am convinced of the sincerity of these advocates for the mentally ill, but am equally convinced they are now fighting the wrong fight."

Actually we are not. We are fighting for our freedom. We fight for our right to not to be deprived of freedom unless we commit a crime, basically the same right that other people who have not been stigmatized with a DSM label have. If you want to preemptively lock up people who are likely to be convicted of a crime based on demographic information alone, you should start a campaign to lock up young black males from inner cities, who have a high probability of ending up in jail. Good luck confronting the NAACP.

"The risks and priorities have shifted—fifty years ago a million patients languished in snake pit hospitals, now they languish in much more dangerous and degrading snake pit prisons."

Actually, this is a lie, that continues to be a lie regardless of the number of times that it is repeated,

"The timing isn’t right, with the prison (and jail) boom coming long after the bulk of the mental-hospital releases. And the demographics aren’t right, either. As Steven Raphael and Michael Stoll point out in Do Prisons Make Us Safer? (just published), mental-hospital patients tended to be white, female, and elderly, while prisoners are disproportionately black, male, and young."

Mr Frances, if you want to understand our point of view, think in term of "rape victims". That is how we feel. Our freedom is non negotiable, period, end of the story.

When that asshole Ronald Reagan was shot and his assailant was found not guilty by reason of mental illness, Idaho, became one of the jerk off knee jerk states that took mental illness or defect away from the truly mentally ill. You commit a crime in Idaho and are truly mentally ill, you will go to prison. All because conservative legislators wanted to avenge the shooting of the worst president we ever had. I wish I knew a way to change this. Imagine all this fuss and revenge for an asshole like Reagan.